Nardil News

Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Nardil or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Nardil is not approved for use in pediatric patients. (See Warnings: Clinical Worsening and Suicide Risk, Precautions: Information for Patients, and Precautions: Pediatric Use)

NARDIL has been found to be effective in depressed patients clinically characterized as "atypical," "nonendogenous," or "neurotic." These patients often have mixed anxiety and depression and phobic or hypochondriacal features. There is less conclusive evidence of its usefulness with severely depressed patients with endogenous features.

NARDIL should rarely be the first antidepressant drug used. Rather, it is more suitable for use with patients who have failed to respond to the drugs more commonly used for these conditions.

Clinical Trials Related to Nardil (Phenelzine)

Phenelzine Sulfate in Treating Patients With Non-metastatic Recurrent Prostate Cancer [Recruiting]
This phase II trial studies phenelzine sulfate in treating patients with prostate cancer
that has not spread to other parts of the body and has come back. Phenelzine sulfate is a
type of antidepressant that works by decreasing the amount of a protein called monoamine
oxidase (MAO). MAO drugs may have an anticancer effect in prostate cancer.

Phenelzine Sulfate and Docetaxel in Treating Patients With Prostate Cancer With Progressive Disease After First-Line Therapy With Docetaxel [Recruiting]
This phase II trial studies how well giving phenelzine sulfate together with docetaxel works
in treating patients with prostate cancer that is growing, spreading, or getting worse after
first-line therapy with docetaxel. Phenelzine sulfate may stop the growth of tumor cells by
blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as
docetaxel, work in different ways to stop the growth of tumor cells, either by killing the
cells or by stopping them from dividing. Phenelzine sulfate may also help docetaxel work
better by making tumor cells more sensitive to the drug. Giving phenelzine sulfate together
with docetaxel may kill more tumor cells.

Supplemental Transcranial Magnetic Stimulation (TMS) vs. Standard Medication Monotherapy for Treating Major Depression: An Exploratory Field Study [Withdrawn]
A. Introduction to the Problem
This field experiment is intended to explore whether supplemental transcranial magnetic
stimulation (TMS) is more effective than standard medication mono-therapy for the treatment
of major depressive disorder. Transcranial magnetic stimulation (TMS) is now included in the
practice guidelines of the American Psychiatric Association for the treatment of major
depression.
B. Importance of the Area of Study
The safety, efficacy and value of TMS treatment has been established through the four-phase
FDA approval process. The evidence of TMS safety and efficacy derives from multiple, peer
reviewed, double-blind, randomized, control trials (RCT) with sham control as well as strict
enrollment and methodological requirements. TMS is now used in actual clinical practice and
there is an opportunity to extend laboratory research and typical, highly controlled field
settings to applied settings. This study is designed to gather data on safety, efficacy and
utility of TMS as it is used in clinical practice.
C. Need for Additional Research
Efficacy and safety of these interventions have been scientifically established and
meta-analyses of these studies underscore the efficacy and safety of two treatment
interventions to be employed in this study: 1) standard medication monotherapy and 2)
standard medication therapy supplemented with TMS. However, many authors conclude that
depression can be difficult to treat and there is an ongoing need for additional research.
Depression remains a major public health problem.

Treatment-Resistant Depression, Hippocampus Atrophy and Serotonin Genetic Polymorphism [Completed]
Reduction of volume of the hippocampus has been associated with major depression in many
studies. It has been suggested that antidepressants may protect against hippocampus volume
loss in humans associated with multiple episodes of depression and may also reverse the
reduction of volume caused by the depression. In addition, genetic markers for serotonin are
implicated with depression, and may be an indication of reduced response to antidepressant
treatments.
This study aims to enroll patients who are defined as having treatment resistant depression
(no remission after at least 2 treatments trials with an antidepressant). They will receive
an MRI scan at the initial visit and either 6 months after sustained remission or 12 months
after they enter the study for non-remitters. They will also be asked to give a blood sample
for genotyping. They will be matched by age and handedness to healthy volunteers with no
personal history of depression who will also receive an MRI scan and genotyping.
The first aim is to compare hippocampal volume of depressed subjects to healthy controls. It
is anticipated that subjects will initially have smaller hippocampal volume but of those who
sustain remission, there will be a small increase in hippocampal volume. It is also
anticipated that specific genetic markers will be related to individuals response to
antidepressant treatments.

PATIENT REVIEWS / RATINGS / COMMENTS

Based on a total of 1 ratings/reviews, Nardil has an overall score of 9. The effectiveness score is 10 and the side effect score is 6. The scores are on ten point scale: 10 - best, 1 - worst.

Nardil review by 52 year old female patient

Rating

Overall rating:

Effectiveness:

Highly Effective

Side effects:

Moderate Side Effects

Treatment Info

Condition / reason:

depression (atypical)

Dosage & duration:

75mg taken 15mg 5 times per day for the period of 18 months

Other conditions:

anxiety

Other drugs taken:

lamictal 150mg per day

Reported Results

Benefits:

A dramatic decrease in the level of depression and a great increase in a feeling of well-being and hope for the future. There were also considerable cognitive benefits: thought processes speeded up, memory became stronger and intellectual creativity increased. Also the constant fatigue that accompanied the depression decreased and this made possible an exercise program that increased energy and enjoyment of strenuous activities. In addition my general and social anxiety decreased dramatically.

Side effects:

The most troublesome side effect was faintness upon rising quickly from a seated (or horizontal) position. On one occasion I lost consciousness and fell. However, this side effect went away after three months or so. There was also some decrease in sexual desire, but this side effect also lessened over time. A side effect that seems to be permanent is lower blood pressure, but this is actually a benefit for most people. I've been told that some people take MAOI's solely to decrease their blood pressure.

Comments:

It takes some time to build up to a clinical dosage. As I recall, my doctor had me take 15mg for a weak, 30mg for two weeks, 45mg for two weeks until I had built up to 75mg. I did not begin to feel the antidepressant effect until I reached 45mg. When I reached 60mg the antidepressant effect had kicked in fully and I even experienced a period (two or three weeks) of a mild euphoria, which I have been told is fairly typical. My doctor thought that a slow buildup of the drug in my system was the most effective treatment. He also had me taking Lamictal (150mg per day), which he thought might spark a stronger reaction to Nardil. There are also some diet restrictions: no aged cheeses and no aged meats. Also, some cold medications must be avoided.